Individual
TASHA HALSEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3105 LAKE SHORE DRIVE, SUITE 4-101, ANCHORAGE, AK 99517
(907) 302-9164
(209) 759-2653
Mailing address
PO BOX 241224, ANCHORAGE, AK 99524
(907) 302-9164
(209) 759-2653
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-172924
AK
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N.A
N.A
AK
Enumeration date
05/28/2021
Last updated
10/26/2021
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